Periodontal conditions and associated factors among adults and the elderly: findings from the first <i>National Oral Health Survey</i> in Uruguay

Lorenzo, Susana M.; Alvarez, Ramón; Andrade, Ernesto; Piccardo, Virginia; Francia, Alejandro; Massa, Fernando; Correa, Marcos Britto; Peres, Marco Aurélio

doi:10.1590/0102-311X00012115

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Artigo • Cad. Saúde Pública 31 (11) • Nov 2015 • https://doi.org/10.1590/0102-311X00012115 copy

Periodontal conditions and associated factors among adults and the elderly: findings from the first National Oral Health Survey in Uruguay

Enfermedad periodontal y factores asociados en la población adulta y adulta mayor: primer Relevamiento Nacional de Salud Bucal en Uruguay

A doença periodontal e fatores associados entre adultos e idosos: dados da Pesquisa Nacional de Saúde Bucal no Uruguai

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aims of this study were to assess the prevalence of periodontal conditions in the Uruguayan adult and elderly population and its association with socioeconomic and behavioral characteristics. Data from adults (35-44, n = 358) and elderly (65-74, n = 411) who participated in the first National Oral Health Survey, Uruguay, 2011, were used. The survey included a household questionnaire addressing socioeconomic characteristics, and tobacco use. Bleeding on probing (BOP), periodontal pockets (CPI) and clinical attachment loss (CAL) were measured by clinical examination. A multivariable analysis was carried out. Considering both age groups, the prevalence of mild/severe periodontal disease was 21.8% and 9.12% for severe periodontal disease. Adjusted analyses revealed an association between high education and all outcomes. Attendance at dental services was negatively associated with BOP and mild to severe periodontitis. Periodontal outcomes were higher in disadvantaged socioeconomic groups. Tobacco consumption has a strong association with periodontal disease in the elderly.

Periodontal Diseases; Dental Health Surveys; Adult; Aged

Independent variable	BOP (n = 604)	Periodontal disease moderate/severe
	BOP (n = 604)	Moderate/Severe (n = 612)	Severe (n = 612)
	% (95%CI)	% (95%CI)	% (95%CI)
Block 1
Sex
Female	35.6 * (29.7-42.0)	12.9 ** (9.7-17.0)	6.5 * (4.5-9.4)
Male	45.9 * (38.1-53.9)	30.1 ** (23.8-38.2)	11.7 * (7.8-17.2)
Region
Provinces	37.3 (31.2-43.8)	23.3 (18.3-29.2)	11.2 ** (8.1-15.1)
Capital	43.8 (36.3-51.4)	20.6 (15.2-27.4)	7.5 ** (4.4-12.4)
Age group (years)
35-44	43.8 (36.9-49.8)	16.5 ** (12.1-22.0)	5.9 (3.6-9.5)
65-74	35.0 (28.2-42.5)	34.7 ** (27.7-42.4)	17.0 (12.1-23.2)
University degree
Yes	30.6 ** (22.6-39.8)	14.8 * (9.7-21.9)	3.9 ** (2.1-7.2)
No	46.0 ** (40.0-52.2)	25.6 * (20.5-31.4)	11.8 ** (8.5-16.1)
Block 2
Type of health services
Private	37.6 *** (31.4-44.2)	21.4 (16.5-27.4)	8.8 (6.0-12.6)
Public	46.7 *** (38.6-66.1)	22.2 (16.4-29.3)	9.9 (6.2-15.6)
Time since last dental visit
Up to 12 months	34.0 * (26.9-41.8)	18.4 ** (13.1-25.2)	7.3 (4.4-11.9)
More than 12 months	46.9 * (40.1-53.8)	24.6 ** (19.2-30.9)	10.9 (7.6-15.5)
Never used dental services	90.3 * (46.1-99.0)	94.6 ** (0.6-99.5)	25.3 (4.4-71.3)
Tooth brushing
≥ twice a day	36.1 * (30.8-41.9)	17.9 ** (14.0-22.7)	8.1 (5.7-11.4)
< twice a day	57.1 * (45.8-67.7)	35.1 ** (25.4-46.2)	12.5 (7.2-20.9)
Tobacco use
Do not smoke/not daily	39.3 (33.8-44.9)	20.6 (16.3-25.7)	8.6 (6.0-12.1)
Up to 10 cigarettes/day	54.5 (32.9-74.4)	23.5 (11.6-41.7)	9.3 (2.6-28.1)
More than 10 cigarretes/day	44.8 (31.6-58.8)	27.7 (17.6-41.7)	11.9 (6.7-20.4)

Independent variables	BOP (n = 588)			Periodontal disease
	BOP (n = 588)			Moderate/severe (n = 599)			Severe (n = 599)
	PR_adjusted	95%CI	p-value	PR_adjusted	95%CI	p-value	PR_adjusted	95%CI	p-value
Block 1
Sex			0.077			< 0.001			0.065
Female	1.00			1.00			1.00
Male	1.24	0.98-1.59		2.25	1.57-3.23		2.00	1.03-2.93
Region			0.120
Provinces	1.00						1.00
Capital	1.20	0.95-1.54					0.68	0.37-1.23
Age group (years)			0.092			< 0.001			< 0.001
35-44	1.00			1.00			1.00
65-74	0.81	0.63-1.04		2.09	1.47-2.98		2.97	1.66-5.29
University			0.010			0.018			< 0.001
Yes	1.00			1.00			1.00
No	1.51	1.10-2.07		1.71	1.10-2.67		2.93	1.49-5.77
Block 2
Type of health services			0.236
Private	1.00
Public	1.07	0.84-1.37
Time since last dental visit			0.001			0.032			0.583
Up to 12 months	1.00			1.00			1.00
12 or more months	1.30	1.00-1.68		1.10	0.75-1.61		1.16	0.91-2.86
Never used dental services	2.00	1.35-2.98		2.63	1.29-5.38		1.54	1.37-6.14
Tooth brushing			0.024			0.156			0.895
≥ twice a day	1.00			1.00			1.00
< twice a day	1.37	1.04-1.79		1.37	0.89-2.10		1.03	0.54-1.95
Tobacco use			0.980			0.550			0.392
Do not smoke /not daily	1.00			1.00			1.00
Up to 10 cigarettes/day	1.30	0.84-2.25		1.10	0.57-2.10		1.05	0.26-4.24
10 or more cigarretes/day	1.00	0.71-1.42		1.33	0.81-2.16		1.65	0.79-3.44

Independent variables	BOP (n = 338)			Periodontal disease
	BOP (n = 338)			Moderate/severe (n = 347)			Severe (n = 347)
	PR_adjusted	95%CI	p-value	PR_adjusted	95%CI	p-value	PR_adjusted	95%CI	p-value
Block 1
Sex			0.180			< 0.001			0.192
Female	1.00			1.00			1.00
Male	1.22	0.93-1.68		2.93	1.64-5.25		1.82	0.71-4.62
Region			0.060
Provinces	1.00
Capital	1.32	0.94-1.69
University			0.026			0.060			0.007
Yes	1.00			1.00			1.00
No	1.57	0.86-1.60		2.22	0.98-5.03		7.93	1.76-35.8
Block 2
Type of health services			0.331						0.336
Private	1.00						1.00
Public	1.16	0.86-1.56					1.41	0.56-5.54
Time since last dental visit			0.002
Up to 12 months	1.00
12 or more months	1.19	0.88-1.61
Never used dental services	1.88	1.32-2.67
Tooth brushing			0.087			0.111
≥ twice a day	1.00			1.00
< twice a day	1.35	0.96-1.90		1.71	0.89-3.30
Tobacco use			0.761			0.780			0.687
Do not smoke/not daily	1.00			1.00			1.00
Up to 10 cigarettes/day	1.15	0.65-2.04		1.28	0.55-2.98		1.68	0.41-6.91
10 or more cigarretes/day	0.90	0.61-1.34		1.21	0.61-2.37		0.87	0.28-2.69

Independent variables	BOP (n = 250)			Periodontal disease
	BOP (n = 250)			Moderate/severe (n = 265)			Severe (n = 265)
	PR_adjusted	95%CI	p-value	PR_adjusted	95%CI	p-value	PR_adjusted	95%CI	p-value
Block 1
Sex			0.153			0.012			0.110
Female	1.00			1.00			1.00
Male	1.33	0.98-1.83		1.69	1.12-2.56		1.64	0.89-3.30
Region			0.690			0.220			0.115
Provinces	1.00			1.00			1.00
Capital	0.92	0.62-1.37		1.35	0.83-2.19		0.57	0.29-1.15
University			0.166			0.925			0.093
Yes	1.00			1.00			1.00
No	1.38	0.87-2.20		0.98	0.66-1.46		1.90	0.90-4.03
Block 2
Type of health services			0.408
Private	1.00
Public	0.82	0.53-1.29
Time since last dental visit			0.128			0.806			0.618
Up to 12 months	1.00			1.00			1.00
12 or more months	1.66	1.02-2.72		1.04	0.67-1.63		0.79	0.43-1.46
Never used dental services	1.61	0.59-5.01		1.44	0.70-2.97		1.10	0.47-2.56
Tooth brushing			0.231			0.624
≥ twice a day	1.00			1.00			1.00
< twice a day	1.28	0.86-1.90		1.11	0.79-1.75		1.05	0.57-1.95
Tobacco use			0.016			0.009			< 0.001
Do not smoke /not daily	1.00			1.00			1.00
Up to 10 cigarettes/day	1.72	1.05-2.83		0.72	0.20-2.59		3.58	1.36-1.94
10 or more cigarretes/day	1.81	1.16-2.83		1.92	1.25-2.97		3.59	1.84-7.00

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[1] Correspondence
S. M. Lorenzo. Calle 3 s/n Solar 18, Manz. 73, Toledo, Canelones. 91100, Uruguay. susana.of.lorenzo@gmail.com